The number of children going to hospital after self-harming are at a five-year high. The BBC reported yesterday that admissions of girls aged between 10 and 14 had increased by nearly 93 percent in that time, with a 45 percent rise in boys, from 454 to 659.
Self-harm is often, clumsily, branded a "girl's condition". Like eating disorders, it's wrapped up in old ideas about the way mental health problems should manifest themselves in men – we're not supposed to dodge our food, and we're certainly not supposed to cut ourselves. But this is a dangerous mantra, a relic from the era of the stiff-upper lip that's probably best jettisoned. Children – especially boys – are suffering in silence because of it.
It's difficult to talk about self-harm whatever the sufferer's gender, because it's an acute expression of something deeper. Crudely put, it's a way of making internal pain tangible, visible. If your skin burns and bleeds as you cut it open, you'll be distracted from the pain of your thoughts. This is a human trait, not a feminine one. It's genderless. Ageless. Age-old.
"Self-harm is a coping mechanism," Lucie Russell, of young person's mental health charity YoungMinds, told me. "And it's very self-destructive. It's done as a personal punishment, to release the pain inside by experiencing pain on the outside. The reasons for a young person self-harming are numerous – economical issues, addiction problems, family breakdown. These all affect mental health." There's also the more modern issue of the internet, and the 24/7 online framework it allows kids to operate within. Russell argues that this leaves them wide open to bullying – a prime motivator for youth self-harm – from all angles.
According to the BBC, the increase in the total sufferers may also be down to better number counting. In other words, the problem itself might not be growing; it might just be that people are paying more attention to it. Nevertheless, Russell believes these latest numbers, which have come from the government's Health and Social Care Information Centre, are just the tip of the iceberg – especially because of the problem of boys not wanting to publicise their issues by visiting A&E.
Because of overwhelming news like this and this and this and this and this and this and this and this and this (you get the idea), the government has recently declared that £30 million is being put into mental health support at A&E units. In their Autumn Statement, they also committed to a £100-million mental healthcare project for young people over the next five years.
This all sounds excellent. But there can be no guarantees that change is coming. With mental illness, there are no defined edges. Even the term itself feels incorrect – a tiny umbrella for a deluge of afflictions. You can't go into your local GP, tick a few boxes and come out ten minutes later with a diagnosis, a cure and a raspberry lollipop. Mental health problems are multi-faceted, complex and shape-shifting. Mental health treatment needs to reflect that.
"Yes, there's a new £30 million investment into A&E for mental health. But we're not yet sure how that will be divided," Russell told me. "It's good, but we don't know precisely what it's being spent on. This needs to be about prevention and early intervention." Prevention and early intervention aren't always the watchwords; mental health care in NHS hospitals is dogged by a lack of consistency. In November, a report showed that 32 hospitals throughout the UK were treating their self-harm patients very differently. So, how could they be trusted to invest their part of the £30m in ways that meet the approval of experts?
It is sadly very easy to find horror stories in this country regarding our poor treatment of the mentally ill – and especially the young – but it's not the people working within mental health care who are to blame, or the NHS itself
In another example from 2008, the Improving Access to Psychological Therapies initiative gave £400 million to local commissioners to provide treatment. Yet, according to the Economic and Social Research Council in 2012, this mental health designated money is often spent on other NHS services, against protocol, which is questionable at best.
The report makes for head-shaking reading. Richard Layard, its author, noted: "When everyone praises early intervention, it is particularly shocking that the sharpest cuts today are those affecting children." Layard argues that the most vulnerable people in our society are being put on scales and weighed up against budgets. It's pretty sickening.
Currently, only 13 percent of the NHS budget is spent on mental health. The Regulator Monitor recently suggested a further 20 percent cut in funding. Considering the sheer scale of the issue, this is fucking absurd. While penny-pinching critics may point to an overspend in NHS mental health provision, there's strong evidence to suggest that the only reason it costs the UK economy an estimated £100 billion a year is because the money is so inefficiently spent. It's not like this is a secret – the information is out there.
50 percent of all illnesses reported by under 65s are mental health issues. Yet only 25 percent of sufferers received any help whatsoever. Just think about that for a second. Every other person in a GP waiting room is going in because of something concerning their mental wellbeing and only a quarter of them get any help. According to MindEd, 76 percent of children below the age of 15 suffering from mental health problems do not receive any treatment whatsoever.
"Children self-harm because they don't have any support," said Russell. "If there was more support there would be less people self-harming. We need to think about how to build resilience in young people to deal with the pressure that they're under. Schools, for example, shouldn't be just about exams – they should be about building character and self-confidence."
"We also need to ensure that we equip parents so that they can have conversations with their children about how they're getting on. We need more places where parents and young people can get advice. In person, on the phone, online. We need to make sure that GPs get sufficient training and that teachers are skilled up on how to detect signs of mental illness."
I spoke to someone who works in a London Accident and Emergency unit – who, tellingly, wanted to remain anonymous – who said that, once the children pass through the doors, "it's already too late". They've already started and it's incredibly hard to stop them once they do.
"Most symptoms of mental illness in a person develop before they're 15," the anonymous health worker told me. "We know that. So what we need to do is save them before they're in trouble. But that's not currently how our health service is arranged."
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